CMS Price Transparency Data

Ultrasound, leg veins (duplex)

Facility: Loma Linda University Children's Hospital

Billing Code: 93970 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93970
Insurance Median: $1,187
Cash Discount Price: $1,402
vs. Medicare Baseline: 4.87x Medicare

The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Loma Linda University Children's Hospital is $1,187. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,402. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.87x the Medicare baseline. Located in 11234 Anderson Street Suite A, Loma Linda, CA.

Cash / Self-Pay

$1,402

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,187

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)

Cash / Self-Pay: $1,402 (575%)

Insurance Median: $1,187 (487%)

Cash: $1,402 (575% of Medicare)

Ins. Median: $1,187 (487% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 487% of the Medicare baseline (a markup of 387%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Inland Empire Health Plan (Iehp)	$283 - $307	116%
Alpha Care Medical Group	$307 - $461	126%
Dignity Health	$307 - $461	126%
Epic Health Plan	$307 - $1,246	126%
Kaiser Foundation Hospitals	$307 - $2,078	126%
Upland Medical Group	$307	126%
Vantage Medical Group	$307 - $461	126%
Molina Healthcare Of Ca	$387 - $412	159%
Heritage Provider Network	$504	207%
Adventist Health	$623	256%
Lluh Dept Of Risk Management	$748	307%
UnitedHealthcare	$895 - $1,588	367%
Blue Shield Of California	$1,259 - $1,907	516%
Global Benefits Group	$1,870	767%
Temecula Valley Physicians Medical Group	$1,870	767%
Trivalley Medical Group	$1,870	767%
Blue Cross Blue Shield	$1,914	785%
Cigna	$1,994 - $2,306	818%
Networks By Design	$2,025	831%
Aetna	$2,044	838%
Multiplan	$2,493	1023%
Galaxy Health	$2,649	1087%
Prime Health Services	$2,649	1087%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,402.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 93970.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Loma Linda University Children's Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 93970.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.